Anatomy of pregnancy and birth – vulva

What is the vulva?

The vulva is the external part of the female genitalia (sex organs).

The vulva includes the:

• labia majora — outer folds of skin, also known as ‘outer lips’
• labia minora — hairless, inner folds of skin, also known as ‘inner lips’
• glans clitoris — the visible portion of the clitoris
• vestibule — opening of the vagina and urethra
• hymen — a thin piece of skin at the entrance of your vagina
• perineum — the skin between the vagina and the anus

Sometimes, people use the term ‘vagina’ to refer to the external female genitalia, but it is more correct to call this part of the female body the vulva. The internal parts of the female reproductive system include the vagina, cervix and uterus.

The vulva varies widely in appearance from person to person. Some people’s labia minora extend further beyond the labia majora. The size, colour and shape of the labia majora and minora also vary widely. Many people worry that their genitals don’t look ‘normal’. However, it’s important to remember that there is a very wide range of ‘normal’.

Visit the Labia Library for more information about labia, including a photo library.

It is also normal to experience changes in the way your vulva looks during different stages of the menstrual cycle, during pregnancy and after menopause.

Does the vulva change during pregnancy?

Oestrogen and progesterone levels increase during pregnancy. These increases can cause increased blood flow to the vaginal area and the vulva, which may cause your vulva to swell or darken the vulvar skin. It can also increase your chance of developing vulvar varicosities, which are varicose veins in the vulvar area.

The hormonal changes associated with pregnancy may also lead to changes in the balance of bacteria and yeast in your vagina. This can increase your risk of vaginal infections, such as thrush, so it’s important to see your doctor if you have symptoms of an infection.

You may also experience an increase in normal vaginal discharge during pregnancy.

What role does the vulva play in labour and birth?

The vulva, especially the perineum, plays an important role in stretching to accommodate your baby’s head during a vaginal birth. In some cases, this stretching during birth leads to tearing of the skin and tissues of the perineum. Small tears may heal on their own, but larger ones may need to be repaired by your midwife or doctor with stitches.

You may choose to massage your perineum (or have your partner do it) in the weeks leading up to birth, to reduce the risk of tearing.

Learn more about perineal massage.

Does the vulva change after birth?

It’s normal for the vulva to look different at different life stages, from puberty to menopause.

After a vaginal birth, the vulva may look different. In particular, the labia minora may look more stretched out. This is normal, and nothing to worry about.

As long as you don’t see a lump, or have any trouble with your bladder, bowel and sexual function, it’s nothing to worry about.

When should I see my doctor?

It is normal to have some changes in the appearance of your vagina during pregnancy and after birth, but you should see your doctor if you are concerned. You can also ask your doctor at your 6-week postnatal check.

You should also see your doctor if you have symptoms of problems including:

• vulval pain, itch or discomfort
• a change the colour or odour of your vaginal discharge
• pain while urinating
• pain during sex

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Resources and support

• Jean Hailes has information about a range of topics relating to female reproductive health.
• Visit the Labia Library for more information about labia, including a photo library.
• CareDownThere has information and advice about caring for your vulva.